雌激素或避孕药治疗青春期功能性子宫出血的效果分析

A retrospective study on estrogen or contraceptives in the treatment of dysfunctional uterine bleeding in adolescent patients

目的探讨雌激素及避孕药治疗青春期功能性子宫出血(功血)的止血效果和适宜的起始剂量。方法对我院1990年2月至2005年7月治疗的106例的临床资料进行回顾性分析。结果本组106例中采用苯甲酸雌二醇(E2)组56例,口服结合雌激素(CEE)组30例,口服避孕药(COCs)组20例。快速控制出血率和快速止血率CEE组与E2组相比有显著延长,COCs与E2组效果相似。控制出血时间和完全止血时间E2起始剂量≤8 mg/d组和>8 mg/d组相比无显著差异;CEE起始剂量<7.5 mg/d与≥7.5 mg/d组相比也无显著差异,但需加量治疗率明显增加;COCs(妈富隆)≤3片/d与>3片/d组相比也无显著差异。结论用COCs治疗青春期功血在控制出血方面效果与E2的效果类似。增加上述各药的剂量,并不增强其止血效果。

Objective： To investigate the clinical efficacy of estrogen or contraceptives in the treatment of acute bleeding episode of dysfunctional uterine bleeding （DUB） in adolescent patients and the optimal starting dosage of the drugs. Methods： The clinical records of 106 girls with DUB and moderate or severe anemia from February 1990 to July 2005 were retrospectively analyzed. Results： All 106 patients received hormonal therapy. Fifty six patients were treated with estradiol benzoate （E2）, 30 patients with conjugated equine estrogen （CEE） and 20 patients with combined oral contraceptives （COCs）. The rates of rapidly controlling bleeding and the rates of rapidly stopping bleeding in E2 group were higher than those in CEE group and were similar to those in COCs group. The different starting dosages （≤8 mg/d and 〉8 mg/d in E2 group, 〈7.5 mg/d and 〉/7.5 mg/d of CEE group, ≤3 pills/d and 〉3 pills/d of COCs group） showed no difference in the time intervals for controlling bleeding and for completely stopping bleeding, but during the treatment with CEE, the rate of increasing the dosage in 〈7.5 mg/d group was higher than that in 〉/7.5 mg/d group （40% vs. 6%）. Conclusions： The clinical efficacy of E2 on DUB in adolescent patients is similar to that of COCs. And the efficacies of Ez, CEE and COCs at different dosages are similar.